Hosted by Christine Betzold MSN NP IBCLC

"Teeth, Teething, and Biting
 in the breastfed child”

WHAT ABOUT TEETH? Most children get their teeth between 7-12 months of age, although they can appear earlier or later. Every baby is unique. Breastmilk contains fluoride it is no longer routinely recommended unless the area water is not adequately fluoridated. Ask your health care provider whether your child needs fluoride.

CARE OF THE TEETH AND GUMS. Start early when baby is young by rubbing gums with a wet washcloth daily. Once teeth erupt start brushing with a soft toothbrush—toothpaste is optional. If you use toothpaste use a very small pea-sized amount. Once your child can hold a toothbrush allow child to brush supervised and with some assistance. Recommendations regarding the first dental check up vary from 1-3 years. Check with your dentist or health care provider.

WHAT ABOUT TEETHING? Some infants need to nurse more while teething and some nurse less. Biting may occur when an infant is teething. Using a cold teething ring, breastmilk popsicles, or offering some toast prior to nursing may make your child more comfortable and less likely to bite. Sometimes new top front teeth come in with sharp edges. If the sharp edges are causing soreness then a clean nail file can be used to gently file down the pointy edges. MOST MOTHERS FIND TEETH DON’T CREATE DISCOMFORT OR HINDER NURSING.

What about BITING?* When an infant is actively nursing his tongue comes out over his lower teeth. So, a baby who is actively breastfeeding cannot bite the mother without biting his own tongue. Now, try placing your thumb in your mouth with your tongue out over your lower teeth. Now bite. Does it hurt your finger? No, and so biting while nursing won't hurt either. MOST INFANTS LEARN VERY QUICKLY NOT TO BITE.

What are some causes of BITING (or clamping down) other than TEETHING? There are a few situations where biting can be a real problem. Tongue-tied infants may not be able to keep the tongue over the teeth. Some babies bite to slow the flow of milk if, they are poor bolus handlers or mom has a very powerful let-down. Yet, another reason babies clamp down is that the milk flow is too low. Older babies may bite if they are asked to nurse as a distraction or when just wants mom's attention but doesn't really want to nurse.

How can I Anticipate and Prevent being BITTEN? One idea is to teach your baby not to clamp down on the breast (with their gums) BEFORE they have teeth. So, if baby clamps down instantly break the latch-on by placing your finger in the corner of baby's mouth and cover your breast with clothing for a minute or two before resuming nursing. Do this only, once nursing is well established and going well, usually after the sixth week of life. In an older baby, watch for the little smirk that often precedes a bite and if seen, quickly unlatch your baby. Finally when teething, use the aforesaid teething soothers instead of nursing and/or use soothers before nursing for comfort and to lessen the urge to bite.

What to do IF Baby BITES?* First, gently but sternly say, "no" and end the feeding. If baby doesn't promptly let go when you say, "no", then push baby into breast. If baby still doesn't release then apply pressure to baby's jaw. If this still doesn't work, then put the finger inside the mouth while applying downward pressure to the gums. When you end the feeding, you can decisively get the message across if you also place infant on the floor and walk away.

MOST INFANTS LEARN VERY QUICKLY NOT TO BITE.* Another approach, useful for an older baby, would be to play a game, teach the infant to "open" on command along with many other facial expressions (this is also helpful when a child compresses tight enough while nursing to leave little upper teeth prints.) This method has worked where others have failed. Try placing your hand under baby's chin and your thumb near the corner of baby's mouth, so that when the slightest pause in sucking occurs you can push your thumb gently but firmly on the cheek, between the gums. Gingerly persevere in the placement of your hand even if baby bothered by it. Now, by pushing the cheek between the gums it is a natural and appropriate consequence for biting when his or her own cheek gets bitten. Avoid hollering or getting upset if a child bites or child may go on a NURSING STRIKE.

Some Final Thoughts to NIBBLE ON. Remember your baby must pause to pull back the tongue before biting. Baby cannot bite while actively nursing without wounding his or her own tongue. Pulling baby away from your breast is unfortunately the mother's natural impulse, this however will further injure the nipple so try to remember to push instead of pull. Would you stop holding, kissing, cuddling your child if he or she bit you? Of course not, so then why would you stop nursing your child because he or she bit you?